Foreign patients receiving medical treatment in Bay of Plenty cost hospital services an average of $130,000 a year in written off bad debt.
According to figures released to the Bay of Plenty Times under the Official Information Act, more than $150,000 was written off during the 2012 financial year and more than $180,000 was written off in 2013. Last financial year, just under $80,000 was written off.
That adds up to more than $400,000 in the past three years.
As of June 2014, foreign patients owed Bay of Plenty health authorities $129,198.27 in unpaid medical bills, the largest amount in three years.
Bay of Plenty DHB general manager of governance and quality Gail Bingham said the issue of unpaid bills was taken very seriously. "We takes all steps possible to recover monies owed, including taking offenders to court," she said.
"However, the DHB is limited in what it can do in terms of debt relating to emergency care.
"All patients requiring emergency treatment are seen without question and then subsequently invoiced.
"There is currently no requirement for people entering New Zealand to have health insurance, which would help address this issue."
If a foreign patient didn't pay their bill when they were discharged they would be contacted to make arrangements for payment seven days from the date of invoice, she said.
If no arrangements were made, they would be called and sent a statement and letter requesting they make payment within 7-14 days.
If no payments were received by the middle of the next month, the debtor would be handed over to debt collectors.
Last year, Brookfield Indian national Harpreet Singh was ordered in the Tauranga District Court to pay $3794.05 in reparation after he impersonated an associate while receiving free urgent surgery at Tauranga Hospital. Singh had no medical insurance.
Nationally, district health boards write off millions of dollars each year after treating foreign patients.
Patients from some countries were covered under their visa status. Patients from Australia, the United Kingdom, Tokelau, Niue and the Cook Islands have reciprocal agreements to cover the treatment.
Foreign patients injured by accidents may also be covered by ACC.
Ministry of Health spokesman John Hazeldine said district health boards were responsible for recovering debts from non-eligible patients.
"The ministry recognises that this is not always possible and compensates DHBs with a higher level of debt write-off through its funding," Mr Hazeldine said.
Health boards can advise Immigration New Zealand of a patient's debt, as well as contracting debt collection agencies to chase up medical bills.